The Impact of Mitral Disease Etiology on Operative Mortality After Mitral Valve Operations

The Annals of Thoracic Surgery
J Scott RankinVinay Badhwar

Abstract

The pathoetiology of mitral regurgitation (MR) has been suggested as a mediator of outcomes after mitral valve (MV) operations, particularly in ischemic functional mitral regurgitation (IMR). This study examined the independent association of MV etiology with mortality. The Society of Thoracic Surgeons Database was utilized to assess all patients undergoing MV replacement or repair from 2011 to 2014. Patients who underwent concomitant surgical ablation, septal defect closure, tricuspid valve repair, or coronary artery bypass grafting were included. All other concomitant operations were excluded, producing a final cohort of 89,085 patients. A hierarchical etiology decision tree was developed to categorize the population into eight etiology groups: endocarditis, reoperation, acute IMR, rheumatic, uncommon etiologies (hypertrophic obstructive cardiomyopathy, trauma, tumor, or congenital), degenerative primary MR, chronic IMR, and pure annular dilatation. The statistical association of etiology with unadjusted and risk-adjusted operative mortality was evaluated by logistic regression and supplemented by sensitivity analyses using established risk models. The decision tree showed that etiology categories appeared clinically aligned ...Continue Reading

Citations

Mar 3, 2019·Heart·Nozomi Watanabe
Jul 2, 2020·JAMA Cardiology·Vinay BadhwarDavid M Shahian
Jul 23, 2020·Journal of the American Heart Association·David Messika-ZeitounMaurice Enriquez-Sarano
Apr 13, 2021·The Journal of Thoracic and Cardiovascular Surgery·Cheng-Yu ChenShao-Wei Chen
Mar 15, 2020·The Journal of Thoracic and Cardiovascular Surgery·Jintao FuXu Meng
Feb 19, 2019·The Journal of Thoracic and Cardiovascular Surgery·Vinay BadhwarGorav Ailawadi
Sep 26, 2020·JACC. Cardiovascular Interventions·Francesco Maisano

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